Utilization Management Specialist I — Behavioral Health

SUN Behavioral Health; Houston (TX); On-site; USD 30,000 - 47,000; Part time

Benefits offered by this job

401(k) Plan with company match

Employee Assistance Program (EAP)

Employee Discount Savings Program

Job summary

SUN Behavioral Health Houston seeks a case management coordinator to support the continuum of care from admission through discharge. You will assist with authorization of admissions, process retroactive reviews and appeals, and ensure coverage for patients with managed care and Medicaid/Medicare plans.

Responsibilities include documenting patient status, coordinating with physicians and the Business Office, and participating in quality initiatives.

Qualifications

• High school diploma or GED mandatory.
• CPR and de-escalation certification required.
• Preferred LMSW/LPCa license or behavioral health/business degree.
• Minimum 1 year of healthcare experience.

Responsibilities

• Coordinate case management strategies from pre-hospitalization through discharge.
• Assist with admission authorizations and insurance documentation.
• Conduct retroactive reviews and appeals to secure coverage.
• Communicate with physicians, nursing, and insurance for patient care.
• Participate in performance improvement activities and staff meetings.

Skills

CPR certification

De-escalation skills

Healthcare experience

Education

High school diploma or GED

LMSW/LPCa license or behavioral health/business BA

Job description

SUN Behavioral Health Houston seeks a case management coordinator to support the continuum of care from admission through discharge. You will assist with authorization of admissions, process retroactive reviews and appeals, and ensure coverage for patients with managed care and Medicaid/Medicare plans.

Responsibilities include documenting patient status, coordinating with physicians and the Business Office, and participating in quality initiatives.